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The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group

by Raina Rupesh , Ohls, Robin , Goldstein, Stuart L , Guillet Ronnie , Mahan, John D , Brophy, Patrick D , Mammen Cherry , Rademacher, Erin , Perazzo Sofia , Woroniecki, Robert , Arwa, Nada , Revenis, Mary , Rastogi Shantanu , Chishti, Aftab S , Smith, Alexandra , DuPont, Tara , Khokhar Surender , Fuloria Mamta , D’Angio Carl , Ingraham, Susan , Duara Shahnaz , Kumar, Deepak , Wazir Sanjay , Askenazi David J , Soranno, Danielle E , Boohaker, Louis J , Rohatgi Smriri , Colaizy, Tarah T , Hanna, Mina , Bonachea, Elizabeth M , Staples, Amy , Charlton, Jennifer R , Gist, Katja M , Hingorani Sangeeta , Synnes, Anne , Mhanna, Maroun J , Sessions, Cole F , Jetton, Jennifer G , Fletcher, Jeffery , Keefe, Davis T , Griffin, Russell , Swanson, Jonathan R , Ambalavanan Namasivayam , Bhutada Alok , Starr, Michelle , Kaskel, Frederick J , Sethi, Sidharth K , Wintermark Pia , Wong, Craig S , Abitbol, Carolyn L , Sridhar Shanty , Reidy, Kimberly , Gien, Jason , Kent, Alison , Kupferman, Juan C , Milner, Lawrence , Mian Ayesa , Selewski, David T , Sarkar Subrata , Ray, Patricio E , Joseph, Catherine , Nathan, Amy T , Akcan-Arikan Ayse , Rhee, Christopher J , Juul Sunny , DeFreitas Marissa , Zappite

in Babies / Birth weight / Clinical outcomes / Gestational age / Neonatal care / Physical growth / Postpartum period

2020

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The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group

in Babies / Birth weight / Clinical outcomes / Gestational age / Neonatal care / Physical growth / Postpartum period

2020

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The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group

in Babies / Birth weight / Clinical outcomes / Gestational age / Neonatal care / Physical growth / Postpartum period

2020

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Journal Article

The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group

Raina Rupesh,

Ohls, Robin,

Goldstein, Stuart L,

Guillet Ronnie,

Mahan, John D,

Brophy, Patrick D,

Mammen Cherry,

Rademacher, Erin,

Perazzo Sofia,

Woroniecki, Robert,

Arwa, Nada,

Revenis, Mary,

Rastogi Shantanu,

Chishti, Aftab S,

Smith, Alexandra,

DuPont, Tara,

Khokhar Surender,

Fuloria Mamta,

D’Angio Carl,

Ingraham, Susan,

Duara Shahnaz,

Kumar, Deepak,

Wazir Sanjay,

Askenazi David J,

Soranno, Danielle E,

Boohaker, Louis J,

Rohatgi Smriri,

Colaizy, Tarah T,

Hanna, Mina,

Bonachea, Elizabeth M,

Staples, Amy,

Charlton, Jennifer R,

Gist, Katja M,

Hingorani Sangeeta,

Synnes, Anne,

Mhanna, Maroun J,

Sessions, Cole F,

Jetton, Jennifer G,

Fletcher, Jeffery,

Keefe, Davis T,

Griffin, Russell,

Swanson, Jonathan R,

Ambalavanan Namasivayam,

Bhutada Alok,

Starr, Michelle,

Kaskel, Frederick J,

Sethi, Sidharth K,

Wintermark Pia,

Wong, Craig S,

Abitbol, Carolyn L,

Sridhar Shanty,

Reidy, Kimberly,

Gien, Jason,

Kent, Alison,

Kupferman, Juan C,

Milner, Lawrence,

Mian Ayesa,

Selewski, David T,

Sarkar Subrata,

Ray, Patricio E,

Joseph, Catherine,

Nathan, Amy T,

Akcan-Arikan Ayse,

Rhee, Christopher J,

Juul Sunny,

DeFreitas Marissa,

Zappite

2020

Overview

BackgroundWe evaluated the epidemiology of fluid balance (FB) over the first postnatal week and its impact on outcomes in a multi-center cohort of premature neonates from the AWAKEN study.MethodsRetrospective analysis of infants <36 weeks’ gestational age from the AWAKEN study (N = 1007). FB was defined by percentage of change from birth weight. Outcome: Mechanical ventilation (MV) at postnatal day 7.ResultsOne hundred and forty-nine (14.8%) were on MV at postnatal day 7. The median peak FB was 0% (IQR: −2.9, 2) and occurred on postnatal day 2 (IQR: 1,5). Multivariable models showed that the peak FB (aOR 1.14, 95% CI 1.10–1.19), lowest FB in first postnatal week (aOR 1.12, 95% CI 1.07–1.16), and FB on postnatal day 7 (aOR 1.10, 95% CI 1.06–1.13) were independently associated with MV on postnatal day 7. In a similar analysis, a negative FB at postnatal day 7 protected against the need for MV at postnatal day 7 (aOR 0.21, 95% CI 0.12–0.35).ConclusionsPositive peak FB during the first postnatal week and more positive FB on postnatal day 7 were independently associated with MV at postnatal day 7. Those with a negative FB at postnatal day 7 were less likely to require MV.

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